CH6 - 3) Chronic Leukemia

Question 1

What is chronic leukemia?

Answer 1

Neoplastic proliferation of mature circulating lymphocytes

Question 2

What is chronic leukemia characterized by?

Answer 2

a high WBC count

Question 3

Describe the onset of chronic leukemia?

Answer 3

Usually insidious in onset and seen in older adults

Question 4

What is chronic lymphocytic leukemia?

Answer 4

Neoplastic proliferation of naive B cells that co-express CD5 and CD20;

Question 5

What is the most common leukemia overall?

Answer 5

Chronic lymphocytic leukemia (CLL)

Question 6

In CLL what is seen on the blood smear?

Answer 6

Increased lymphocytes and smudge cells are seen on blood smear

Question 7

small lymphocytic lymphoma

Answer 7

In CLL, with involvement of lymph nodes leads to generalized lymphadenopathy

Question 8

What are the complications of CLL?

Answer 8

1) Hypogammaglobulinemia, 2) autoimmune hemolytic anemia, 3) Richter transformation

Question 9

What is the most common of death in CLL?

Answer 9

infection

Question 10

What is Richter transformation?

Answer 10

transformation to diffuse large B-cell lymphoma

Question 11

What is Richter transformation marked clinically by?

Answer 11

an enlarging lymph node or spleen

Question 12

What is Hairy cell leukemia?

Answer 12

Neoplastic proliferation of mature B cells

Question 13

What characterizes hairy cell leukemia?

Answer 13

hairy cytoplasmic processes

Question 14

What are hairy cell leukemia cells positive for?

Answer 14

tartrate-resistant acid phosphatase (TRAP).

Question 15

What are the clinical features for hairy cell leukemia?

Answer 15

Splenomegaly, dry tap on bone marrow aspiration

Question 16

Why is there splenomegaly in hairy cell leukemia?

Answer 16

Due to accumulation of hairy cells in red pulp

Question 17

Why is there a dry tap on bone marrow aspiration in hairy cell leukemia?

Answer 17

due to marrow fibrosis

Question 18

How is lymphadenopathy related to hair cell leukemia?

Answer 18

Lymphadenopathy is usually absent

Question 19

What drug is used in the treatment of hairy cell leukemia?

Answer 19

2-CDA (cladribine)

Question 20

How does hair cell leukemia respond to cladribine?

Answer 20

excellent response

Question 21

How does cladribine work?

Answer 21

Its an adenosine deaminase inhibitor, adenosine accumulates to toxic levels in neoplastic B cells.

Question 22

What is adult T cell leukemia?

Answer 22

Neoplastic proliferation of mature CD4+ T cells (ATLL)

Question 23

What is adult T cell leukemia associated with?

Answer 23

Associated with HTLV-I (human T cell lymphotrophic virus -1)

Question 24

Where is ATLL associated with HTLV-1 most commonly seen in?

Answer 24

Japan and the Caribbean

Question 25

What are the clinical features for ATLL?

Answer 25

include rash (skin infiltration), generalized lymphadenopathy with hepatosplenomegaly, and lytic (punched-out) bone lesions with hypercalcemia

Question 26

What is mycosis fungoides?

Answer 26

Neoplastic proliferation of mature CD44 T cells that infiltrate the skin, producing localized skin rash, plaques, and nodules

Question 27

What are Patitrier microabscesses?

Answer 27

Aggregates of neoplastic cells in the epidermis

Question 28

Sezary syndrome

Answer 28

cells can spread to involve the blood, producing Sezary syndrome.

Question 29

What are Sezary cells?

Answer 29

Characteristic lymphocytes with cerebri form nuclei

Question 30

What would you see on blood smear in mycosis fungoides?

Answer 30

Sezary cells